Liothyronine Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Hypothyroidism

Initial dose: 25 mcg orally once a day; may be increased by up to 25 mcg every 1 to 2 weeks depending on the patient's clinical response and laboratory findings

Maintenance dose: 25 to 75 mcg daily

Usual Adult Dose for Myxedema

Initial dose: 5 mcg orally once a day; may be increased by 5 to 10 mcg every 1 to 2 weeks depending on the patient's clinical response and laboratory findings

When treatment is up to 25 mcg/day, the dosage may be increased by 5 to 25 mcg every week or two until a satisfactory therapeutic response is attained.

Maintenance dose: 50 to 100 mcg daily

Usual Adult Dose for Myxedema Coma

25 to 50 mcg intravenously

If the patient has known or suspected cardiovascular disease, then an initial dose of 10 to 20 mcg in conjunction with cardiac monitoring is recommended.

Subsequent doses should be determined by the patient's clinical condition and response to treatment. Generally, doses should be administered at least 4 hours and no more than 12 hours apart. Caution is advised in adjusting the dose due to the potential of acute and large changes to precipitate adverse cardiovascular events.

Available clinical data indicate reduced mortality in patients receiving at least 65 mcg/day in the initial days of treatment. However, there is limited clinical experience with dosages above 100 mcg/day.

Oral thyroid hormone therapy should be substituted as soon as the patient is stable and able to take oral medication. If levothyroxine rather than liothyronine is used, the prescriber should bear in mind that there is a delay of several days in the onset of levothyroxine activity and that intravenous therapy should be discontinued gradually.

Usual Adult Dose for Thyroid Suppression Test

75 to 100 mcg orally once a day for 7 days

Radioactive (131) iodine uptake should be determined before and after the administration of thyroid hormone. If thyroid function is under normal control, the radioactive iodine uptake should drop significantly after treatment. A 50% or greater suppression of uptake indicates a normal thyroid-pituitary axis and rules out thyroid gland autonomy.

Liothyronine should be administered cautiously if there is a strong suspicion of thyroid gland autonomy, as exogenous hormone effects will be additive to those of the endogenous source.

Usual Adult Dose for TSH Suppression

Initial dose: 5 mcg orally once a day; may be increased by 5 to 10 mcg every 1 to 2 weeks depending on the patient's clinical response and laboratory findings

When treatment is up to 25 mcg/day, the dosage may be increased by 12.5 to 25 mcg every week or two until a satisfactory therapeutic response is attained.

Maintenance dose: 75 mcg daily

Usual Pediatric Dose for Hypothyroidism

Congenital hypothyroidism/Hypothyroidism:
Infants and Children less than or equal to 3 years:
Initial dose: 5 mcg orally once a day; may be increased by 5 mcg every 3 days to a maximum dosage of 20 mcg/day for infants and 50 mcg/day for children 1 to 3 years of age.

Hypothyroidism:
Initial dose: Children: 5 mcg orally once a day. Increase in 5 mcg/day increments every 3 to 4 days
Usual maintenance dose:
Infants: 20 mcg orally once a day
Children 1 to 3 years: 50 mcg orally once a day
Children greater than 3 years: Full adult dosage may be necessary

Goiter (nontoxic):
Children:
Initial dose: 5 mcg orally once a day. Increase in 5 mcg/day increments every 1 to 2 weeks
Maintenance dose: 15 to 20 mcg orally once a day

Goiter (nontoxic):
Children: 5 mcg orally once a day. Increase in 5 mcg/day increments every 1 to 2 weeks
Maintenance dose 15 to 20 mcg orally once a day

Renal Dose Adjustments

Data not available. However, liothyronine is known to be substantially excreted by the kidney, and the risk of toxic reactions may be greater in patients with impaired renal function.

Liver Dose Adjustments

Data not available

Dose Adjustments

Thyroid hormone preparations should be used cautiously in the elderly and in patients with known or suspected cardiovascular disease, including coronary artery disease or angina pectoris. Liothyronine therapy should be initiated at lower dosages (e.g., 5 mcg daily), with due consideration for its relatively rapid onset of action, and increased by no more than 5 mcg increments at 2-week intervals. If a euthyroid state can only be achieved at the expense of aggravating the cardiovascular disease, thyroid hormone dosage should be reduced.

Dialysis

Data not available

Other Comments

Periodic laboratory assessment of thyroid status (e.g., serum T3 and TSH levels) should be performed during liothyronine therapy.

When switching a patient from another thyroid hormone formulation, discontinue the other medication, initiate liothyronine at a low dosage, and increase gradually according to the patient's response. The prescriber should bear in mind that liothyronine has a rapid onset of action and that residual effects of the previous thyroid hormone preparation may persist for the first several weeks of therapy.

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